Différents programmes destinés aux proches des patients atteints de la maladie d’Alzheimer (MA) se sont développés ces dernières années mais les études explorant leurs effets restent encore trop rares en France. Nous avons réalisé une étude qui compare les effets de deux types d’interventions : programme pluridisciplinaire structuré versus prise en charge classique, chez des patients atteints de la MA et leur conjoint.

Seize couples de patients Alzheimer et leurs conjoints ont été inclus dans l’étude et divisés en deux groupes en fonction du suivi dont ils avaient bénéficié sur les deux dernières années dans le même établissement. Les uns avaient participé à un suivi multidisciplinaire standardisé (n=8 couples), les autres étaient suivis de manière classique (n=8). Les variables sociodémographiques et psychopathologiques ont été évaluées chez les conjoints et chez les patients dans le cadre d’entretiens cliniques et par autoquestionnaires.

Le principal résultat significatif montre que l’anxiété état, c’est-à-dire celle en rapport avec la situation d’aide, était moins importante chez les conjoints ayant bénéficié du programme pluridisciplinaire.

Ces résultats préliminaires confirment l’intérêt d’un programme pluridisciplinaire structuré, chez les conjoints de patients atteints de la MA.

Over the last decade, several programs have been developed for caregivers of Alzheimer disease patients. In France however, studies exploring their effects are still scarce. We conducted a study to compare two different interventions: a structured multidisciplinary program versus a classical intervention designed for Alzheimer disease patients and their spouses.

Sixteen couples (Alzheimer’s disease patient and spouse) residing in our administrative district participated in this monocentric study. For at least two years, these couples participated in a multidisciplinary program (n=8 couples) or received usual care (n=8 couples). The multidisciplinary program involved biannual consultations with a neurologist, a neuropsychologist and a psychologist, in addition to an annual meeting, stratified on the patient’s MMSE score, for spouses). Usual care involved biannual consultations with the neurologist. The multidisciplinary program included a psychological intervention based on cognitive behavioral theories and centered on psycho-education, problem solving, adaptation strategies and on prevention of depression and anxiety. The spouses and the patients evaluated the 2-year follow-up during clinical interviews, completed by questionnaires. Sociodemographic data were noted for the patients and their spouses. Levels of depression and anxiety (Mini International Neuropsychiatric Inventory, Montgomery and Asberg Depression Scale, State-Trait Anxiety Inventory), perceived stress (Perceived Stress Scale) and care burden (Zarit Burden Inventory) were evaluated in spouses. Levels of cognitive impairment (Mini Mental State Examination), autonomy (Instrumental Activities of Daily Living), psychological state (Montgomery and Asberg Depression Scale, Covi Anxiety Scale), and behavioral symptoms frequency (Neuropsychiatric Inventory) were assessed in patients.

The main significant result showed that the spouses’ state of anxiety was lower among participants in the multidisciplinary program, compared with the classical neurological intervention. It also was found that the spouses and the patients who participated in this multidisciplinary program were less depressed.

This study shows that a multidisciplinary structured intervention, with only two annual consultations and one annual meeting for spouses, can contribute to decrease significantly the spouses’ state of anxiety. Further studies including a larger number of subjects should be conducted to confirm these findings.